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Demographic and socio-economic predictors of diet quality among adults in Bosnia and Herzegovina

  • Selma Gicevic (a1), Audrey J Gaskins (a1) (a2), Teresa T Fung (a1) (a3), Bernard Rosner (a2) (a4), Edin Sabanovic (a5), Jelena Milesevic (a6), Agnes Kadvan (a6), Emir Kremic (a7) and Walter Willett (a1) (a2) (a8)...



To evaluate associations of demographic and socio-economic factors with diet quality among population subgroups in Bosnia and Herzegovina (B&H).


A cross-sectional analysis of 2017 B&H dietary survey data. Diet quality was assessed by the Prime Diet Quality Score (PDQS) utilizing data from two non-consecutive 24 h diet recalls. Socio-economic variables were extracted from the 2015 B&H Household Budget Survey. Homogeneity of means across population subgroups was evaluated using multivariable regression.


B&H population survey.


A population-based sample of 853 adults.


The mean PDQS was 15·8 (range 7–28 out of a possible 42 points). In general, Bosnian adults had low PDQS due to high intakes of refined grains, high-fat dairy and processed meats, and low intakes of whole grains, nuts and fish. The PDQS was significantly higher (P < 0·0001) among older individuals (17·0) compared with those in the youngest group (14·5), among individuals living in the central and northern regions (16·5) compared with those living in the south (15·1; P < 0·0001), and among people who are married/cohabitating (16·1) v. single (14·8; P = 0·02). In energy-adjusted models, socio-economic status (P = 0·04) and tertiles of household spending (P = 0·002) were inversely associated with the PDQS.


Diet quality in this population was low. Young and middle-aged individuals, singles and those living in the south had significantly lower quality diets compared with other subgroups. Public health action is needed to promote higher consumption of whole grains, nuts and fish, and a higher variety of fruits and vegetables.


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